Technology acceptance and care self-management: consideration in context of chronic care management

With an aging global population, the number of people living with a chronic illness is expected to increase significantly by 2050. If left unmanaged, chronic care leads to serious health complications, resulting in poor patient quality of life and a costly time bomb for care providers. If effectively managed, patients with chronic care tend to live a richer and more healthy life, resulting in a less costly total care solution. This chapter considers literature from the areas of technology acceptance and care self-management, which aims to alleviate symptoms and/or reason for non-acceptance of care, and thus minimise the risk of long-term complications, which in turn reduces the chance of spiralling health expenditure. By bringing together these areas, the chapter highlights areas where self-management is failing so that changes can be made in care in advance of health deterioration.

Educational and psychosocial programmes for adolescents with diabetes: approaches, outcomes and cost-effectiveness

Diabetes incurs heavy personal and health system costs. Self-management is required if complications are to be avoided. Adolescents face particular challenges as they learn to take responsibility for their diabetes. A systematic review of educational and psychosocial programmes for adolescents with diabetes was undertaken. This aimed to: identify and categorise the types of programmes that have been evaluated; assess the cost-effectiveness of interventions; identify areas where further research is required. Sixty-two papers were identified and Subjected to a narrative review. Generic programmes focus on knowledge/skills, psychosocial issues, and behaviour/self-management. They result in modest improvements across a range of outcomes but improvements are often not sustained, suggesting a need for continuous support, possibly integrated into normal care. In-hospital education at diagnosis confers few advantages over home treatment. The greatest returns may be obtained by targeting poorly controlled individuals. Few studies addressed resourcing issues and robust cost-effectiveness appraisals are required to identify interventions that generate the greatest returns on expenditure. (C) 2004 Elsevier Ireland Ltd. All rights reserved.

Liberation or limitation? Understanding Iyengar Yoga as a practice of the self

This article explores the Foucauldian notions of practices of the self and care of the self, read via Deleuze, in the context of Iyengar yoga (one of the most popular forms of yoga currently). Using ethnographic and interview research data the article outlines the Iyengar yoga techniques which enable a focus upon the self to be developed, and the resources offered by the practice for the creation of ways of knowing, experiencing and forming the self. In particular, the article asks whether Iyengar yoga offers possibilities for freedom and liberation, or whether it is just another practice of control and management. Assessing Iyengar yoga via a ‘critical function’, a function of ‘struggle’ and a ‘curative and therapeutic function’, the article analyses whether the practice might constitute a mode of care of the self, and what it might offer in the context of the contemporary need to live better, as well as longer.

Soil fertility management in the mid-hills of Nepal: Practices and perceptions

Sustaining soil fertility is essential to the prosperity of many households in the mid-hills of Nepal, but there are concerns that the breakdown of the traditional linkages between forest, livestock, and cropping systems is adversely affecting fertility. This study used triangulated data from surveys of households, discussion groups, and key informants in 16 wards in eastern and western Nepal to determine the existing practices for soil fertility management, the extent of such practices, and the perception of the direction of changes in soil fertility. The two principal practices for maintaining soil fertility were the application of farmyard manure (FYM) and of chemical fertilizer (mainly urea and diammonium phosphate). Green manuring, in-situ manuring, slicing terrace risers, and burning plant residues are rarely practiced. FYM usage was variable with more generally applied to khet land (average 6053 kg fresh weight manure ha(-1)) than to bari land (average 4185 kg fresh weight manure ha-1) with manure from goats and poultry preferred above that from cows and buffaloes. Almost all households (98%) apply urea to khet land and 87% to bari land, with 45% applying diammonium phosphate to both types of land. Application rates and timings of applications varied considerably both within and between wards suggesting poor knowledge transfer between the research and farming communities. The benefits of chemical fertilizers in terms of ease of application and transportation in comparison with FYM, were perceived to outweigh the widely reported detrimental hardening of soil associated with their continued usage. Among key informants, FYM applied in conjunction with chemical fertilizer was the most popular amendment, with FYM alone preferred more than chemical fertilizer alone - probably because of the latter's long-term detrimental effects. Key informant and householder surveys differed in their perception of fertility changes in the last decade probably because of differences in age and site-specific knowledge. All key informants felt that fertility had declined but among households, only about 40% perceived a decline with the remainder about evenly divided between no change and an increase. Householders with small landholdings (< 0.5 ha) were more likely to perceive increasing soil fertility while those with larger landholdings (> 2 ha) were more likely to perceive declining fertility. Perceived changes in soil fertility were not related to food self-sufficiency. The reasons for the slow spread of new technologies within wards and the poor understanding of optimal use of chemical fertilizers in conjunction with improved quality FYM may repay further investigation in terms of sustaining soil fertility in this region.

Construction management research: a field of application

Research in construction management is diverse in content and in quality. There is much to be learned from more fundamental disciplines. Construction is a sub-set of human experience rather than a completely separate phenomenon. Therefore, it is likely that there are few problems in construction requiring the invention of a completely new theory. If construction researchers base their work only on that of other construction researchers, our academic community will become less relevant to the world at large. The theories that we develop or test must be of wider applicability to be of any real interest. In undertaking research, researchers learn a lot about themselves. Perhaps the only difference between research and education is that if we are learning about something which no-one else knows, then it is research, otherwise it is education. Self-awareness of this will help to reduce the chances of publishing work which only reveals a researcher’s own learning curve. Scientific method is not as simplistic as non-scientists claim and is the only real way of overcoming methodological weaknesses in our work. The reporting of research may convey the false impression that it is undertaken in the sequence in which it is written. Construction is not so unique and special as to require a completely different set of methods from other fields of enquiry. Until our research is reported in mainstream journals and conferences, there is little chance that we will influence the wider academic community and a concomitant danger that it will become irrelevant. The most useful insights will come from research which challenges the current orthodoxy rather than research which merely reports it.

Reactive crisis management in construction projects

Patterns of communication and behaviour emerge within a construction project in response to a construction crisis. This paper investigates, within a grounded theory framework, the nature of these patterns, the sociological and psychological forces which shape them and their relationship with crisis management efficiency. A grounded theory is presented in four parts. The first part conceives a construction crisis as a period of social instability, arising from conflicting interest groups, seeking to exercise power in the pursuit of social structures which suit their political and economic interests. The second part sees a construction crisis as a de-sensitizing phenomenon which results in a period of behavioural instability and conflict which is self-perpetuating. The third part cites social structure as an important influence upon construction crisis management efficiency, in determining the efficiency of information flow, and the level of uncertainty between those affected. The fourth part points to the in-built defence mechanisms which construction crises have and to three managerial ironies which make construction crisis management difficult.

Making sense of supply chain management: acomparative study of aerospace and construction

Current recipes for learning across business sectors too often fail to recognize the embedded and contextual nature of management practice. The existing literature gives little emphasis to the symbiotic relationship between supply chain management and the broader dynamics of context. The aerospace and construction sectors are selected for comparison on the basis that they are so different. The UK aerospace sector has undergone extensive consolidation as a result of the imperatives of global competitive pressures. In contrast, the construction industry has experienced decades of fragmentation and remains highly localized. An increasing proportion of output in the aerospace sector occurs within a small number of large, globally orientated firms. In contrast, construction output is dominated by a plethora of small firms with high levels of subcontracting and a widespread reliance on self-employment. These differences have fundamental implications for the way that supply chain management is understood and implemented in the two sectors. Semi-structured interviews with practitioners from both sectors support the contention that supply chain management is more established in aerospace than construction. The introduction of prime contracting and the increasing use of framework agreements within the construction sector potentially provide a much more supportive climate for supply chain management than has traditionally prevailed. However, progress depends upon an improved continuity of workload under such arrangements.

Facilities management in South East Asia

The purpose of this paper is to provide an insight into the growth stage of facilities management (FM) in the South East Asia region. A questionnaire study of local and international firms operating in South East Asia was used. South East Asia needs to open up to change, particularly with respect to parity in issues of global competition in FM standards. This study is based on a limited sample size using a self-reporting methodology. Further research is needed to further investigate the findings. This paper addresses a unique insight into the contrasting approach to FM in the South East Asia region.

Subjectively construed identities and discourse: towards a research agenda for construction management

Identity issues are under-explored in construction management. We provide a brief introduction to the organization studies literature on subjectively construed identities, focusing on discourse, agency, relations of power and identity work. The construction management literature is investigated in order to examine identity concerns as they relate to construction managers centred on (1) professionalism; (2) ethics; (3) relational aspects of self-identity; (4) competence, knowledge and tools; and (5) national culture. Identity, we argue, is a key performance issue, and needs to be accounted for in explanations of the success and failure of projects. Our overriding concern is to raise identity issues in order to demonstrate their importance to researchers in construction management and to spark debate. The purpose of this work is not to provide answers or to propose prescriptive models, but to explore ideas, raise awareness and to generate questions for further programmatic research. To this end, we promote empirical work and theorizing by outlining elements of a research agenda which argues that 'identity' is a potentially generative theme for scholars in construction management.

The automatic layout model in the sequencing of construction activities of multi-objective diaphragm wall unit by using self-learning neural network

Foundation construction process has been an important key point in a successful construction engineering. The frequency of using diaphragm wall construction method among many deep excavation construction methods in Taiwan is the highest in the world. The traditional view of managing diaphragm wall unit in the sequencing of construction activities is to establish each phase of the sequencing of construction activities by heuristics. However, it conflicts final phase of engineering construction with unit construction and effects planning construction time. In order to avoid this kind of situation, we use management of science in the study of diaphragm wall unit construction to formulate multi-objective combinational optimization problem. Because the characteristic (belong to NP-Complete problem) of problem mathematic model is multi-objective and combining explosive, it is advised that using the 2-type Self-Learning Neural Network (SLNN) to solve the N=12, 24, 36 of diaphragm wall unit in the sequencing of construction activities program problem. In order to compare the liability of the results, this study will use random researching method in comparison with the SLNN. It is found that the testing result of SLNN is superior to random researching method in whether solution-quality or Solving-efficiency.